Abstract
This study investigated the relationship between public healthcare-related features, vaccination rates, and COVID-19 mortality rates in 44 European and South Caucasian countries. The COVID-19 mortality rates were averaged from 21 November 2021 to 4 December 2021, coinciding with the height of the fourth wave of the pandemic. A cross-sectional analysis was conducted using the ordinary least squares (OLS) estimator, the spatial autoregressive (SAR) model, and the spatial error (SEM) model. A cluster analysis was then performed to identify homogeneous groupings of nations exhibiting escalating risk variables for COVID-19 mortality. The results indicated that public health expenditure, healthcare personnel, pharmacists, universal health coverage (UHC), and COVID-19 vaccination rates exhibited significant negative correlations with COVID-19 mortality rates, while out-of-pocket (OOP) spending and the saturation of ordinary and intensive care unit (ICU) beds demonstrated significant positive correlations with COVID-19 mortality rates. Cluster analysis indicated that post-communist and post-Soviet European nations with more decentralized and predominantly private insurance-based healthcare systems exhibited the highest risk variables for COVID-19 mortality. In contrast, Nordic European countries with universal healthcare systems demonstrated the lowest risk. Consequently, nations with publicly funded comprehensive healthcare systems have shown greater efficacy in reducing COVID-19 death rates while alleviating the strain on national healthcare systems. These policy recommendations may be beneficial in the event of similar shocks in the future.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Change history
23 March 2025
In this article, the tables 4 and 5 (Part B) column's enumeration was incorrect. This has been corrected.
Notes
The countries classified as post-communist or post-Soviet European nations included: Azerbaijan, Bulgaria, Croatia, Czech Republic, Estonia, Georgia, Hungary, Latvia, Lithuania, Moldova, Poland, Romania, Russia, Slovak Republic, Slovenia, and Ukraine.
In fact, the UHC index and current health expenditure per capita were highly and positively correlated, evidenced by a Pearson’s correlation coefficient of 0.87.
The incorporation of Russia and South Caucasian nations (Armenia, Azerbaijan, and Georgia) expanded the sample and addressed the spatial relationship between post-communist and post-Soviet countries inside Europe. They share not only borders but also a similar shift from a national healthcare system to one based on insurance, primarily dependent on direct OOP payments (Rechel and McKee, 2009).
The study omitted control variables such as GDP and GNI, which are commonly employed to assess a nation's wealth due to their strong link with public healthcare indicators. For instance, the average GDP per capita in constant 2021 international US dollars (at PPP) (World Bank, 2024) and the average domestic general government health expenditure per capita in international US dollars (at PPP) (World Health Organization, 2023) exhibited a robust positive correlation during the 2015–2020 timeframe. Pearson's correlation coefficient, calculated at 0.88, was significantly high. For the same reason, air pollutants, although identified in the literature as important contributors to the spread and mortality of COVID-19 (Coccia, 2021; Perone, 2022), were omitted from the empirical investigation. This was a critical factor since simultaneous inclusion in the models would have resulted in significant multicollinearity concerns, distorting the interpretation of the models and yielding erroneous results (Yoo et al., 2014).
No data was provided for the Faroe Islands. Nonetheless, due to their status as a self-governing archipelago inside the Kingdom of Denmark, it was presumed that the Faroe Islands and Denmark possessed equivalent levels of democracy. This enabled the preservation of crucial observations in empirical analysis.
I opted to incorporate the female share of the population rather than the male share, as only the former variable demonstrated statistical significance in the multivariate analysis.
The mortality data pertained to the end of 2021, whereas the healthcare factors data (excluding vaccination) primarily corresponded to the period from 2015 to 2020, aligning with the most recent available data at the time of extraction. The discrepancy stems from the fact that healthcare reforms, akin to other policy initiatives, require time to achieve success and exert a significant influence on reality. Consequently, examining the years preceding 2021 offers a more dependable perspective on the healthcare system's framework and assets.
Whereas 100 signifies that 100% of the population is covered by essential health services, and 0 signifies that none is covered.
Total COVID-19 hospitalization data were sourced from Mathieu et al. (2023), with the exception of the Faroe Islands (The Government of the Faroe Islands, 2021), Georgia (Agenda.Ge, 2021), Germany (Robert Koch Institute, 2023), and Moldova (United Nations Moldova, 2021). Data concerning the number of hospital beds per 100,000 people for 2020 (or the most recent year) were sourced from OECD (2022), with the exception of Albania, Armenia, Azerbaijan, Bosnia and Herzegovina, Georgia, Moldova, Russia, and Ukraine, which were obtained from Our World in Data (2023). Data pertaining to the Faroe Islands were obtained from the Faroese Ministry of Health (2023).
Data regarding COVID-19 hospitalizations in ICU were obtained from Mathieu et al. (2023), with the exception of the Faroe Islands (Landspítali University Hospital, 2022), Georgia (Agenda.Ge, 2021), Hungary (Cabinet Office of the Prime Minister of Hungary, 2021), Latvia (National Health Service–Republic of Latvia, 2021), Lithuania (Lietuvos Nacionalinis Radijas ir Televizija, 2022), and Norway (Government.no, 2021). Data on ICU beds per 100,000 inhabitants for 2020 (or the most recent year) were sourced from OECD (2021), with the exception of Armenia (bne IntelliNews, 2020), Bulgaria (OECD/European Observatory on Health Systems and Policies 2021), the Faroe Islands (Landssjúkrahúsið National Hospital, 2023), Georgia (Tarkhnishvili, 2020), Iceland (Fouda et al., 2020), Malta (Farrugia, 2020), Montenegro (European Observatory on Health Systems and Policies 2020), Slovakia (Bauer et al., 2021), Slovenia (Bauer et al., 2021), the UK (Ewbank et al., 2021), and Ukraine (Shulzhenko, 2020). Additionally, it should be noted that the data for Belgium, Denmark, Hungary, Ireland, Italy, and Sweden, pertained to the peak number of ICU beds in 2020.
Due to the presence of negative values in the data, a constant is added prior to executing the log-transformation.
For instance, refer to Strauss (2017) for a comprehensive and extensive elucidation of the nuances and characteristics of Ward’s procedure.
The median age was selected instead of the percentage of the population aged 65 or older. The latter was statistically significant solely when ICU bed saturation (at 5%), pharmacists, or the total number of COVID-19 vaccine doses provided per 100 persons (both at 10%) were used as explanatory variables. The results are available upon reasonable request.
While OOP was not significant in OLS estimations, it had statistical significance in the spatial analysis (Sect. 5.2).
The lockdown measures significantly impacted international air transport, which served as the primary channel for disease transmission (Krisztin et al., 2020). In this context, it is reasonable to infer that the simplest means of traveling to other countries was via border crossings.
Figure 7 showed a map of the three increasing risk clusters for COVID-19 mortality.
Denmark, Finland, Iceland, Norway, and Sweden were among the Nordic nations. The Faroe Islands were excluded due to insufficient data.
This rationale may also apply to the other post-communist and post-Soviet European nations, which exhibited an average UHC of 71.98% and OOP expenditure of 27.59%.
Switzerland, with a public share of 34.11%, was a significant outlier. This may be attributed to the highly decentralized nature of the Swiss healthcare system, which predominantly depends on compulsory private health insurance (Braendle and Colombier, 2020).
References
ABC.AZ. (2022). Number of Azerbaijani citizens living below poverty line unveiled, Abc.az news, October 10, 2022. Retrieved from: https://abc.az/en/news/105090. Accessed 10 November 2023.
Agenda.Ge. (2021). News. Retrieved from: https://agenda.ge/en/news/news. Accessed 14 October 2023.
Agouridis, A. P., Karageorgos, S. A., & Tsioutis, C. (2023). Role of gender in hesitancy toward the COVID-19 vaccine beyond medical students: Reply to Rujittika Mungmunpuntipantip and Viroj Wiwanitkit. Germs, 13(4), 385–387. https://doi.org/10.18683/germs.2023.1409
Agrawal, V., Sood, N., & Whaley, C. M. (2023). The impact of the global COVID-19 vaccination campaign on all-cause mortality (No. w31812). National Bureau of Economic Research. Retrieved from: https://www.nber.org/papers/w31812. Accessed 23 April 2024.
Alam, M. F., Wildman, J., & Rahim, H. A. (2023). Income inequality and its association with COVID-19 cases and deaths: A cross-country analysis in the Eastern Mediterranean region. BMJ Global Health, 8(11), e012271. https://doi.org/10.1136/bmjgh-2023-012271
Al-Amin, M., Islam, M. N., Li, K., Shiels, N., & Buresh, J. (2022). Is there an association between hospital staffing levels and inpatient-COVID-19 mortality rates? PLoS ONE, 17(10), e0275500. https://doi.org/10.1371/journal.pone.0275500
Alberti, V., Alonso Raposo, M., Attardo, C., Auteri, D., Ribeiro Barranco, R., Batista e Silva, F., & Zulian, G. (2019). The future of cities—Opportunities, challenges and the way forward. In I. Vandecasteele, C. Baranzelli, A. Siragusa, J.P. Aurambout (Eds.), EUR 29752 EN. Publications Office, Luxembourg, 2019, JRC116711. https://doi.org/10.2760/375209
Almeida, A. (2024). The trade-off between health system resiliency and efficiency: Evidence from COVID-19 in European regions. The European Journal of Health Economics, 25(1), 31–47. https://doi.org/10.1007/s10198-023-01567-w
Alwhaibi, A., Alrwaished, A., Binobydaan, S. M., Alawwad, S., Wajid, S., Bablghaith, S., Alghadeer, S., & Al Arifi, M. N. (2021). Role of pharmacist during COVID-19 pandemic: A retrospective study focused on critically ill COVID-19 patients. Saudi Pharmaceutical Journal, 29(9), 1050–1055. https://doi.org/10.1016/j.jsps.2021.07.010
Anselin, L. (1998). Spatial econometrics: Methods and models. Kluwer.
Anselin, L. (2013). Spatial econometrics: Methods and models (Vol. 4). Springer.
Anselin, L. (2020). Distance-band spatial weights, GeoDa, 10 August 2020 (updated). Retrieved from: https://geodacenter.github.io/workbook/4b_dist_weights/lab4b.html. Accessed 22 February 2024.
Arbel, R., Hammerman, A., Sergienko, R., Friger, M., Peretz, A., Netzer, D., & Yaron, S. (2021). BNT162b2 vaccine booster and mortality due to Covid-19. New England Journal of Medicine, 385(26), 2413–2420. https://doi.org/10.1056/NEJMoa2115624
Arbel, R., & Pliskin, J. (2022). Vaccinations versus lockdowns to prevent COVID-19 mortality. Vaccines, 10(8), 1347. https://doi.org/10.3390/vaccines10081347
Aristodemou, K., Buchhass, L., & Claringbould, D. (2021). The COVID-19 crisis in the EU: The resilience of healthcare systems, government responses and their socio-economic effects. Eurasian Economic Review, 11, 251–281. https://doi.org/10.1007/s40822-020-00162-1
Azerbaijan Tourism Board. (2022). A look back at the tourism industry achievements of Azerbaijan in the ‘new normal’. January 18, 2022. Retrieved from: https://www.tourismboard.az/news/688-a-look-back-at-the-tourism-industry-achievements-of-azerbaijan-in-the-new-normal. Accessed 28 November 2023.
Bachmann, P., & Frutos-Bencze, D. (2022). R&D and innovation efforts during the COVID-19 pandemic: The role of universities. Journal of Innovation & Knowledge, 7(4), 100238. https://doi.org/10.1016/j.jik.2022.100238
Bailey, K. L., Sayles, H., Campbell, J., Khalid, N., Anglim, M., Ponce, J., & Hanson, C. (2022). COVID-19 patients with documented alcohol use disorder or alcohol-related complications are more likely to be hospitalized and have higher all-cause mortality. Alcoholism: Clinical and Experimental Research, 46(6), 1023–1035. https://doi.org/10.1111/acer.14838
Banila N. (2022). Romania's tourist numbers up 46% y/y in 2021—Table. SeeNews in Brief, Bucharest, February 3, 2022. Retrieved from: https://seenews.com/news/romanias-tourist-numbers-up-46-yy-in-2021-table-771878. Accessed 28 November 2023.
Bascle, G. (2008). Controlling for endogeneity with instrumental variables in strategic management research. Strategic Organization, 6(3), 285–327. https://doi.org/10.1177/1476127008094339
Bauer, J., Brüggmann, D., Klingelhöfer, D., Maier, W., Schwettmann, L., Weiss, D. J., & Groneberg, D. A. (2020). Access to intensive care in 14 European countries: A spatial analysis of intensive care need and capacity in the light of COVID-19. Intensive Care Medicine, 46(11), 2026–2034. https://doi.org/10.1007/s00134-020-06229-6
Bauer, P., Brugger, J., König, F., & Posch, M. (2021). An international comparison of age and sex dependency of COVID-19 deaths in 2020: A descriptive analysis. Scientific Reports, 11(1), 1–11. https://doi.org/10.1038/s41598-021-97711-8
Beylik, U., Cirakli, U., Cetin, M., Ecevit, E., & Senol, O. (2022). The relationship between health expenditure indicators and economic growth in OECD countries: A Driscoll–Kraay approach. Frontiers in Public Health, 10, 1050550. https://doi.org/10.3389/fpubh.2022.1050550
bne IntelliNews. (2020). Armenia ‘has just 26 intensive care beds left for COVID-19 patients', May 25, 2020. Retrieved from: https://www.intellinews.com/armenia-has-just-26-intensive-care-beds-left-for-covid-19-patients-183939/. Accessed 2 December 2023.
Bo, Y., Guo, C., Lin, C., Zeng, Y., Li, H. B., Zhang, Y., Hossain, M. S., Chan, J. W., Yeung, D. W., Kwok, K. O., Wong, S. Y., Lau, A. K., & Lao, X. Q. (2020). Effectiveness of non-pharmaceutical interventions on COVID-19 transmission in 190 countries from 23 January to 13 April 2020. International Journal of Infectious Diseases, 102, 247–253. https://doi.org/10.1016/j.ijid.2020.10.066
Bohle, D., & Eihmanis, E. (2022). East Central Europe in the COVID-19 crisis. East European Politics, 38(4), 491–506. https://doi.org/10.1080/21599165.2022.2122051
Bok, K., Sitar, S., Graham, B. S., & Mascola, J. R. (2021). Accelerated COVID-19 vaccine development: Milestones, lessons, and prospects. Immunity, 54(8), 1636–1651. https://doi.org/10.1016/j.immuni.2021.07.017
Braendle, T., & Colombier, C. (2020). Budgetary targets as cost-containment measure in the Swiss healthcare system? Lessons from Abroad. Health Policy, 124(6), 605–614. https://doi.org/10.1016/j.healthpol.2020.05.007
Brauner, J. M., Mindermann, S., Sharma, M., Johnston, D., Salvatier, J., Gavenčiak, T., Stephenson, A. B., Leech, G., Altman, G., Mikulik, V., Norman, A. J., Monrad, J. T., Besiroglu, T., Ge, H., Hartwick, M. A., Teh, Y. W., Chindelevitch, L., Gal, Y., & Kulveit, J. (2021). Inferring the effectiveness of government interventions against COVID-19. Science, 2021, 1.
Bray, I., Gibson, A., & White, J. (2020). Coronavirus disease 2019 mortality: A multivariate ecological analysis in relation to ethnicity, population density, obesity, deprivation and pollution. Public Health, 185, 261–263. https://doi.org/10.1016/j.puhe.2020.06.056
Cabinet Office of the Prime Minister of Hungary. (2021). About hungary: News in brief. Retrieved from: https://abouthungary.hu/. Accessed 2 December 2023.
Cameron, A. C., & Trivedi, P. K. (1990). The information matrix test and its applied alternative hypotheses. Working paper 372, University of California–Davis, Institute of Governmental Affairs. Retrieved from: https://cameron.econ.ucdavis.edu/research/imtest_impliedalternatives_ucdwp372.pdf. Accessed 25 February 2024.
Carozzi, F., Provenzano, S., & Roth, S. (2024). Urban density and COVID-19: Understanding the US experience. The Annals of Regional Science, 72(1), 163–194. https://doi.org/10.1007/s00168-022-01193-z
Castagna, F., Xue, X., Saeed, O., Kataria, R., Puius, Y. A., Patel, S. R., & Jorde, U. P. (2022). Hospital bed occupancy rate is an independent risk factor for COVID-19 inpatient mortality: A pandemic epicentre cohort study. British Medical Journal Open, 12(2), e058171. https://doi.org/10.1136/bmjopen-2021-058171
Centers for Disease Control and Prevention. (2024). COVID-19: Underlying medical conditions, 12 April 2024. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html. Accessed 28 April 2024.
Chan, L. Y., Yuan, B., & Convertino, M. (2021). COVID-19 non-pharmaceutical intervention portfolio effectiveness and risk communication predominance. Scientific Reports, 11(1), 1–17. https://doi.org/10.1038/s41598-021-88309-1
Chang, D., Chang, X., He, Y., & Tan, K. J. K. (2022). The determinants of COVID-19 morbidity and mortality across countries. Scientific Reports, 12(1), 5888. https://doi.org/10.1038/s41598-022-09783-9
Charrad, M., Ghazzali, N., Boiteau, V., & Niknafs, A. (2014). NbClust: an R package for determining the relevant number of clusters in a data set. Journal of Statistical Software, 61, 1–36. https://doi.org/10.18637/jss.v061.i06
Chen, Y. T. (2023). Effect of vaccination patterns and vaccination rates on the spread and mortality of the COVID-19 pandemic. Health Policy and Technology, 12(1), 100699. https://doi.org/10.1016/j.hlpt.2022.100699
Chien, C., & Chen, W. (2020). Meteorological impacts on the incidence of COVID-19 in the US. Stochastic Environmental Research and Risk Assessment, 34(10), 1675–1680. https://doi.org/10.1007/s00477-020-01835-8
Christophi, C. A., Sotos-Prieto, M., Lan, F. Y., Delgado-Velandia, M., Efthymiou, V., Gaviola, G. C., & Kales, S. N. (2021). Ambient temperature and subsequent COVID-19 mortality in the OECD countries and individual United States. Scientific Reports, 11(1), 8710. https://doi.org/10.1038/s41598-021-87803-w
Cifuentes-Faura, J. (2021). Factors influencing the COVID-19 mortality rate in the European Union: Importance of medical professionals. Public Health, 200, 1–3. https://doi.org/10.1016/j.puhe.2021.09.003
Coccia, M. (2021). High health expenditures and low exposure of population to air pollution as critical factors that can reduce fatality rate in COVID-19 pandemic crisis: A global analysis. Environmental Research, 199, 111339. https://doi.org/10.1016/j.envres.2021.111339
Costa, S., Romão, M., Mendes, M., Horta, M. R., Rodrigues, A. T., Carneiro, A. V., Martins, A. P., Mallarini, E., Naci, H., & Babar, Z. (2022). Pharmacy interventions on COVID-19 in Europe: Mapping current practices and a scoping review. Research in Social and Administrative Pharmacy, 18(8), 3338–3349. https://doi.org/10.1016/j.sapharm.2021.12.003
Czech Statistical Office. (2022). Tourism-4. quarter of 2021, February 9, 2022. Retrieved from: https://www.czso.cz/csu/czso/ari/tourism-4-quarter-of-2021. Accessed 29 November 2023.
Damdar, G. T. (2022). Role of clinical pharmacist in COVID-19 crisis. Hospital Pharmacy, 57(1), 7–10. https://doi.org/10.1177/0018578720985429
de la Maisonneuve, C., Égert, B., & Turner, D. (2022). Quantifying the macroeconomic impact of COVID-19-related school closures through the human capital channel. OECD Economics Department Working Papers, No. 1729, OECD Publishing, Paris. https://doi.org/10.1787/eea048c5-en. Accessed 14 October 2024.
De Gier, B., Van Asten, L., Boere, T. M., Van Roon, A., Van Roekel, C., Pijpers, J., Van Werkhoven, C. H., Van den Ende, C., Hahné, S. J., De Melker, H. E., Knol, M. J., & Van den Hof, S. (2023). Effect of COVID-19 vaccination on mortality by COVID-19 and on mortality by other causes, the Netherlands, January 2021–January 2022. Vaccine, 41(31), 4488–4496. https://doi.org/10.1016/j.vaccine.2023.06.005
Demirgüç-Kunt, A., Lokshin, M., & Torre, I. (2021). The sooner, the better: The economic impact of non-pharmaceutical interventions during the early stage of the COVID-19 pandemic. Economics of Transition and Institutional Change, 29(4), 551–573. https://doi.org/10.1111/ecot.12284
Donath, C., Grässel, E., Baier, D., Pfeiffer, C., Bleich, S., & Hillemacher, T. (2012). Predictors of binge drinking in adolescents: Ultimate and distal factors—A representative study. BMC Public Health, 12(1), 263. https://doi.org/10.1186/1471-2458-12-263
Dormann, C. F., Elith, J., Bacher, S., Buchmann, C., Carl, G., Carré, G., & Lautenbach, S. (2013). Collinearity: A review of methods to deal with it and a simulation study evaluating their performance. Ecography, 36(1), 27–46. https://doi.org/10.1111/j.1600-0587.2012.07348.x
Drukker, D. M., Egger, P., & Prucha, I. R. (2013). On two-step estimation of a spatial autoregressive model with autoregressive disturbances and endogenous regressors. Econometric Reviews, 32(5–6), 686–733. https://doi.org/10.1080/07474938.2013.741020
Eftekhar Ardebili, M., Naserbakht, M., Bernstein, C., Alazmani-Noodeh, F., Hakimi, H., & Ranjbar, H. (2021). Healthcare providers experience of working during the COVID-19 pandemic: A qualitative study. American Journal of Infection Control, 49(5), 547–554. https://doi.org/10.1016/j.ajic.2020.10.001
Einhorn, E. (2019). Healthcare in the Nordics, Nordics Info (Aarhus University), 25 February 2019. Retrieved from: https://nordics.info/show/artikel/healthcare-in-the-nordic-region. Accessed 2 May 2024.
El-Khatib, Z., Otu, A., Neogi, U., & Yaya, S. (2020). The association between out-of-pocket expenditure and COVID-19 mortality globally. Journal of Epidemiology and Global Health, 10(3), 192–193. https://doi.org/10.2991/jegh.k.200725.001
Epané, J. P., Zengul, F., Ramamonjiarivelo, Z., McRoy, L., & Weech-Maldonado, R. (2023). Resources availability and COVID-19 mortality among US counties. Frontiers in Public Health, 11, 1098571. https://doi.org/10.3389/fpubh.2023.1098571
European Observatory on Health Systems and Policies. (2020). COVID-19 Health System Response Monitor (HSRM): Montenegro, June 1, 2020. Retrieved from: https://eurohealthobservatory.who.int/monitors/hsrm/all-updates/hsrm/montenegro/planning-services. Accessed 5 December 2023.
Ewbank L., Thompson J., McKenna H., Anandaciva S., & Ward D. (2021). NHS hospital bed numbers, The King’s Fund (updated in September 2021). Retrieved from: https://www.kingsfund.org.uk/insight-and-analysis/long-reads/nhs-hospital-bed-numbers. Accessed 5 December 2023.
Faroese Ministry of Health. (2023). The hospital service. Retrieved from: https://www.hmr.fo/en/what-we-do/health-and-prevention/hospitals/three-hospitals/. Accessed 29 November 2023.
Farrugia, C. (2020). 100 ICU beds available for COVID-19 patients, 120 ventilators, Times of Malta, October 14, 2020. Retrieved from: https://timesofmalta.com/article/100-icu-beds-available-for-covid-19-patients-120-ventilators.824584. Accessed 6 December 2023.
Farzanegan, M. R., Gholipour, H. F., Feizi, M., Nunkoo, R., & Andargoli, A. E. (2021). International tourism and outbreak of coronavirus (COVID-19): A cross-country analysis. Journal of Travel Research, 60(3), 687–692. https://doi.org/10.1177/00472875209315
Ferguson, N. M., Laydon, D., Nedjati-Gilani, G., Imai, N., Ainslie, K., Baguelin, M., & Ghani, A. C. (2020). Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand (Vol. 16). London: Imperial College London. https://doi.org/10.25561/77482
Flaxman, S., Mishra, S., Gandy, A., Unwin, H. J., Mellan, T. A., Coupland, H., Whittaker, C., Zhu, H., Berah, T., Eaton, J. W., Monod, M., Ghani, A. C., Donnelly, C. A., Riley, S., Vollmer, M. A., Ferguson, N. M., Okell, L. C., & Bhatt, S. (2020). Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe. Nature, 584(7820), 257–261. https://doi.org/10.1038/s41586-020-2405-7
Fouda, A., Mahmoudi, N., Moy, N., & Paolucci, F. (2020). The COVID-19 pandemic in Greece, Iceland, New Zealand, and Singapore: Health policies and lessons learned. Health Policy and Technology, 9(4), 510–524. https://doi.org/10.1016/j.hlpt.2020.08.015
Frederiksen, N. (2018). Smoking cessation in the Nordic region, Nordic Welfare Centre, February 2018. Retrieved from: https://nordicwelfare.org/wp-content/uploads/2018/03/eng-180307_lankar.pdf. Accessed 12 September 2023.
Gaeta, M., Campanella, F., Capasso, L., Schifino, G. M., Gentile, L. E. A. N. D. R. O., Banfi, G. I. U. S. E. P. P. E., & Ricci, C. (2017). An overview of different health indicators used in the European Health Systems. Journal of Preventive Medicine and Hygiene, 58(2), E114–E120.
Gebremariam, A. G., Abegaz, D., Nigus, H. Y., Argaw, T. L., Gerbaba, M., Genie, M. G., & Paolucci, F. (2024). Vaccine uptake and effectiveness: Why some African countries performed better than the others? Health Policy and Technology, 13(1), 100820. https://doi.org/10.1016/j.hlpt.2023.100820
Geldsetzer, P., Mukama, T., Jawad, N. K., Riffe, T., Rogers, A., & Sudharsanan, N. (2022). Sex differences in the mortality rate for coronavirus disease 2019 compared to other causes of death: An analysis of population-wide data from 63 countries. European Journal of Epidemiology, 37(8), 797–806. https://doi.org/10.1007/s10654-022-00866-5
Government of Albania. (2014). Albania’s economic reform programme 2016–2018. Retrieved from: https://shtetiweb.org/wp-content/uploads/2016/02/Albanias-Economic-Reform-Programme-2016-2018.pdf. Accessed 25 November 2023.
Government.no. (2021). Prime minister’s address to the Storting on the coronavirus pandemic, 30 November 2021. Retrieved from: https://www.regjeringen.no/en/aktuelt/prime-ministers-address-to-the-storting-on-the-coronavirus-pandemic/id2890249/. Accessed 3 December 2023.
Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2017). A primer on partial least squares structural equation modeling (PLS-SEM). Sage Publications.
Hákun Leo, J. (2018). 56% of Faroe Islanders classed as overweight or obese, Local.fo, November 2, 2018. Retrieved from: https://local.fo/56-of-faroe-islanders-classed-as-overweight-or-obese/. Accessed 20 September 2023.
Herre, B., Samborska, V., & Roser, M. (2023). “Tourism” Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/tourism. Accessed 27 November 2023
Herre B., Ortiz-Ospina E., & Roser M. (2024). “Democracy” Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/democracy. Accessed 10 January 2024.
Hess, K., Bach, A., Won, K., & Seed, S. M. (2020). Community pharmacists roles during the COVID-19 pandemic. Journal of Pharmacy Practice. https://doi.org/10.1177/0897190020980626
Hohmann, S., & Lefevre, C. (2014). Post-Soviet transformations of health systems in the south caucasus. Central Asian Affairs, 1(1), 48–70. https://doi.org/10.1163/22142290-00101005
Hoxha, I., Agahi, R., Bimbashi, A., Aliu, M., Raka, L., Bajraktari, I., Beqiri, P., & Adams, L. V. (2022). Higher COVID-19 vaccination rates are associated with lower COVID-19 mortality: A global analysis. Vaccines, 11(1), 74. https://doi.org/10.3390/vaccines11010074
Hristovska Mijovic, B., Spasova Mijovic, T., Trenovski, B., Kozeski, K., Trpkova-Nestorovska, M., & Trajkova-Najdovska, N. (2020). Tobacco consumption in North Macedonia. Analytica, Skopje, North Macedonia. Retrieved from: https://tobaccotaxation.org/cms_upload/pages/files/236_mkd_report_tobacco_consumption.pdf. Accessed 25 September 2023.
International Labour Organization. (2021). World employment and social outlook: Trends 2021. Retrieved from: https://www.oitcinterfor.org/sites/default/files/file_publicacion/outlook_trends_ILO.pdf. Accessed 12 November 2023.
Isabekova, G. (2018). Healthcare workers in the southern caucasus: Availability, migration and patients’ access to healthcare. Caucasus Analytical Digest, 103, 6–17. https://doi.org/10.3929/ethz-b-000269801
Isath, A., Malik, A. H., Goel, A., Gupta, R., Shrivastav, R., & Bandyopadhyay, D. (2023). Nationwide analysis of the outcomes and mortality of hospitalized COVID-19 patients. Current Problems in Cardiology, 48(2), 101440. https://doi.org/10.1016/j.cpcardiol.2022.101440
Ismail, I. M., Rashid, M. I., Ali, N., Altaf, B. A. S., & Munir, M. (2022). Temperature, humidity and outdoor air quality indicators influence COVID-19 spread rate and mortality in major cities of Saudi Arabia. Environmental Research, 204, 112071. https://doi.org/10.1016/j.envres.2021.112071
Jabłońska, K., Aballéa, S., & Toumi, M. (2021). The real-life impact of vaccination on COVID-19 mortality in Europe and Israel. Public Health, 198, 230–237. https://doi.org/10.1016/j.puhe.2021.07.037
Janke, A. T., Mei, H., Rothenberg, C., Becher, R. D., Lin, Z., & Venkatesh, A. K. (2021). Analysis of hospital resource availability and COVID-19 mortality across the United States. Journal of Hospital Medicine, 16(4), 211–214. https://doi.org/10.12788/jhm.3539
Jayadevan, C. M. (2021). Impacts of health on economic growth: Evidence from structural equation modelling. Asia-Pacific Journal of Regional Science, 5(2), 513–522. https://doi.org/10.1007/s41685-020-00182-4
Jin, J. M., Bai, P., He, W., Wu, F., Liu, X. F., Han, D. M., & Yang, J. K. (2020). Gender differences in patients with COVID-19: Focus on severity and mortality. Frontiers in Public Health, 8, 545030. https://doi.org/10.3389/fpubh.2020.00152
Jucker, J. (2022). Popular approval of Covid-19 restrictions is strongly correlated with vaccination rate, Swiss Medical Weekly. Retrieved from: https://smw.ch/index.php/smw/announcement/view/52. Accessed 7 December 2023.
Kapitsinis, N. (2020). The underlying factors of the COVID-19 spatially uneven spread. Initial evidence from regions in nine EU countries. Regional Science Policy & Practice, 12(6), 1027–1046. https://doi.org/10.1111/rsp3.12340
Kapitsinis, N. (2021). The underlying factors of excess mortality in 2020: A cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19. BMC Health Services Research, 21, 1–19. https://doi.org/10.1186/s12913-021-07169-7
Karabulut, G., Zimmermann, K. F., Bilgin, M. H., & Doker, A. C. (2021). Democracy and COVID-19 outcomes. Economics Letters, 203, 109840. https://doi.org/10.1016/j.econlet.2021.109840
Kassambara, A., & Mundt, F. (2020) Factoextra: Extract and visualize the results of multivariate data analyses. R Package Version 1.0.7. Retrieved from: https://CRAN.R-project.org/package=factoextra. Accessed 19 December 2023.
Khorrami, Z., Nili, S., Sharifi, H., Eybpoosh, S., & Shokoohi, M. (2020). Association of cigarette smoking, obesity, and underlying medical conditions with COVID-19 hospitalization and mortality in Iran: A nationwide retrospective ecological study. Medical Journal of the Islamic Republic of Iran, 34, 133. https://doi.org/10.34171/mjiri.34.133
Kim, J. H. (2019). Multicollinearity and misleading statistical results. Korean Journal of Anesthesiology, 72(6), 558–569. https://doi.org/10.4097/kja.19087
Kolak, M., & Anselin, L. (2020). A spatial perspective on the econometrics of program evaluation. International Regional Science Review, 43(1–2), 128–153. https://doi.org/10.1177/0160017619869781
Krause, R., & Smolle, J. (2022). Covid-19 mortality and local burden of infectious diseases: A worldwide country-by-country analysis. Journal of Infection and Public Health, 15(12), 1370–1375. https://doi.org/10.1016/j.jiph.2022.10.018
Krisztin, T., Piribauer, P., & Wögerer, M. (2020). The spatial econometrics of the coronavirus pandemic. Letters in Spatial and Resource Sciences, 13, 209–218. https://doi.org/10.1007/s12076-020-00254-1
Kuehn, B. M. (2021). COVID-19 in clinicians—More cases in women, more deaths in men. JAMA, 325(15), 1498–1498. https://doi.org/10.1001/jama.2021.5500
Kurpas, P. D., Stefanicka-Wojtas, D., Shpakou, A., Halata, D., Mohos, A., Skarbaliene, A., Dumitra, G., Klimatckaia, L., Bendova, J., & Tkachenko, V. (2021). The advantages and disadvantages of integrated care implementation in central and Eastern Europe—Perspective from 9 CEE countries. International Journal of Integrated Care. https://doi.org/10.5334/ijic.5632
Kyriakides, S. (2023). Keynote speech by Commissioner Stella Kyriakides to the conference “At a turning point: Healthcare systems in Central and Eastern Europe” organized by the American Chamber of Commerce to the EU, European Commission, Brussels, 21 April 2023. Retrieved from: https://ec.europa.eu/commission/presscorner/detail/en/speech_23_2409. Accessed 3 May 2024.
Landspítali University Hospital. (2022). COVID-19 á Landspítala. https://www.landspitali.is/um-landspitala/spitalinn-i-tolum/-covid-19-a-landspitala/. Accessed 1 December 2023.
Landssjúkrahúsið National Hospital. (2023). Facts about Landssjúkrahúsið. Retrieved from: https://sv.ls.fo/um-okkum. Accessed 1 December 2023.
LeSage, J., & Pace, K. R. (2009). Introduction to spatial econometrics. Chapman and Hall/CRC.
Liang, J., & Yuan, H. Y. (2022). Assessing the impact of temperature and humidity exposures during early infection stages on case-fatality of COVID-19: A modelling study in Europe. Environmental Research, 211, 112931. https://doi.org/10.1016/j.envres.2022.112931
Liang, L. L., Tseng, C. H., Ho, H. J., & Wu, C. Y. (2020). Covid-19 mortality is negatively associated with test number and government effectiveness. Scientific Reports, 10(1), 12567. https://doi.org/10.1038/s41598-020-68862-x
Lietuvos Nacionalinis Radijas ir Televizija (LRT). (2022). News. Retrieved from: https://www.lrt.lt/en/news-in-english. Accessed 30 November 2023.
Lima, A. O., Lyra, G. B., Abreu, M. C., Oliveira-Júnior, J. F., Zeri, M., & Cunha-Zeri, G. (2020). Extreme rainfall events over Rio de Janeiro State, Brazil: Characterization using probability distribution functions and clustering analysis. Atmospheric Research, 247, 105221. https://doi.org/10.1016/j.atmosres.2020.105221
MacKinnon, J. G., & White, H. (1985). Some heteroskedasticity-consistent covariance matrix estimators with improved finite sample properties. Journal of Econometrics, 29(3), 305–325. https://doi.org/10.1016/0304-4076(85)90158-7
Mahamat-Saleh, Y., Fiolet, T., Rebeaud, M. E., Mulot, M., Guihur, A., El Fatouhi, D., & Severi, G. (2021). Diabetes, hypertension, body mass index, smoking and COVID-19-related mortality: A systematic review and meta-analysis of observational studies. British Medical Journal Open, 11(10), e052777. https://doi.org/10.1136/bmjopen-2021-052777
Mathieu, E., Ritchie, H., Rodés-Guirao, L., Appel, C., Giattino, C., Hasell, J., Macdonald, B., Dattani, S., Beltekian, D., Ortiz-Ospina, E., & Roser, M. (2023). Coronavirus pandemic (COVID-19). Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/coronavirus. Accessed 4 August 2023.
McFadden, D. (1977). Quantitative methods for analyzing travel behaviour of individuals: Some recent developments. Cowles foundation discussion papers. 707. Retrieved from: https://elischolar.library.yale.edu/cowles-discussion-paper-series/707. Accessed 2 February 2024.
Menard, S. (2001). Applied logistic regression analysis (2nd ed.). Sage Publications.
Meslé, M. M., Brown, J., Mook, P., Hagan, J., Pastore, R., Bundle, N., & Pebody, R. G. (2021). Estimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European Region, December 2020 to November 2021. Eurosurveillance, 26(47), 2101021. https://doi.org/10.2807/1560-7917.ES.2021.26.47.2101021
Meslé, M. M. I., Brown, J., Mook, P., Katz, M. A., Hagan, J., Pastore, R., Benka, B., Redlberger-Fritz, M., Bossuyt, N., Stouten, V., Vernemmen, C., Constantinou, E., Maly, M., Kynčl, J., Sanca, O., Krause, T. G., Vestergaard, L. S., Leino, T., Poukka, E., & Pebody, R. (2024). Estimated number of lives directly saved by COVID-19 vaccination programmes in the WHO European Region from December, 2020, to March, 2023: A retrospective surveillance study. The Lancet Respiratory Medicine, 12(9), 714–727. https://doi.org/10.1016/S2213-2600(24)00179-6
Moolla, I., & Hiilamo, H. (2023). Health system characteristics and COVID-19 performance in high-income countries. BMC Health Services Research, 23(1), 244. https://doi.org/10.1186/s12913-023-09206-z
Moran, P. A. (1948). The interpretation of statistical maps. Journal of the Royal Statistical Society Series B (Methodological), 10(2), 243–251. https://doi.org/10.1111/j.2517-6161.1948.tb00012.x
Mugoša, A., Popović, M., Laković, T., & Čizmović, M. (2018). Accelerating progress on effective tobacco tax policies in low- and middle-income countries: national study—Montenegro, Institute of Socio-Economic Analysis (ISEA), Podgorica, Montenegro. Retrieved from: https://tobaccotaxation.org/cms_upload/pages/files/National-study-Montenegro-1.pdf. Accessed 25 November 2023.
Murtagh, F., & Legendre, P. (2014). Ward’s hierarchical agglomerative clustering method: Which algorithms implement Ward’s criterion? Journal of Classification, 31, 274–295. https://doi.org/10.1007/s00357-014-9161-z
Muthukrishnan, J., Vardhan, V., Mangalesh, S., Koley, M., Shankar, S., Yadav, A. K., & Khera, A. (2021). Vaccination status and COVID-19 related mortality: A hospital based cross sectional study. Medical Journal Armed Forces India, 77, S278–S282. https://doi.org/10.1016/j.mjafi.2021.06.034
Nanda, M., & Sharma, R. (2023). A comprehensive examination of the economic impact of out-of-pocket health expenditures in India. Health Policy and Planning, 38(8), 926–938. https://doi.org/10.1093/heapol/czad050
National Health Service—Republic of Latvia. (2021). News. Retrieved from: https://www.vmnvd.gov.lv/en. Accessed 1 December 2023.
National Statistics Office of Georgia. (2024). GEOSTAT database. Retrieved from: https://www.geostat.ge. Accessed 24 December 2024.
Natural Earth. (2009). Admin 0—Countries, version 5.1.1. Retrieved from: https://www.naturalearthdata.com/downloads/10m-cultural-vectors/10m-admin-0-countries/. Accessed 5 January 2024.
Naudé, W., & Nagler, P. (2022). COVID-19 and the city: Did urbanized countries suffer more fatalities? Cities (London, England), 131, 103909. https://doi.org/10.1016/j.cities.2022.103909
Nielsen, J., Nørgaard, S. K., Lanzieri, G., Vestergaard, L. S., & Moelbak, K. (2021). Sex-differences in COVID-19 associated excess mortality is not exceptional for the COVID-19 pandemic. Scientific Reports, 11(1), 1–9. https://doi.org/10.1038/s41598-021-00213-w
Nordic Council of Ministers. (2017). Nordic statistics 2017. https://doi.org/10.6027/ANP2017-748. Accessed 25 November 2023.
OECD. (2021). Health at a glance 2021: OECD Indicators. OECD Publishing, Paris. Retrieved from: https://doi.org/10.1787/ae3016b9-en. Accessed 1 December 2023.
OECD. (2022). Hospital beds. Retrieved from: https://www.oecd-ilibrary.org/sites/518727bb-en/index.html?itemId=/content/component/518727bb-en.. Accessed 15 December 2023.
OECD. (2023). OECD tourism statistics database. Retrieved from: https://www.oecd-ilibrary.org/industry-and-services/data/oecd-tourism-statistics_2b45a380-en. Accessed 27 November 2023.
OECD/European Observatory on Health Systems and Policies. (2021). Bulgaria: Country health profile 2021, state of health in the EU. OECD Publishing, Paris. https://doi.org/10.1787/c1a721b0-en. Accessed 3 December 2023.
Omar, N. S. (2019). Innovation and economic performance in MENA region. Review of Economics and Political Science, 4(2), 158–175.
Omer, S. B., Benjamin, R. M., Brewer, N. T., Buttenheim, A. M., Callaghan, T., Caplan, A., & Hotez, P. J. (2021). Promoting COVID-19 vaccine acceptance: recommendations from the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA. The Lancet, 398(10317), 2186–2192.
Our World in Data. (2023). Hospital beds (per 1000 people). Retrieved from: https://ourworldindata.org/grapher/hospital-beds-per-1000-people
Pecoraro, F., Luzi, D., & Clemente, F. (2021). The efficiency in the ordinary hospital bed management: A comparative analysis in four European countries before the COVID-19 outbreak. PLoS ONE, 16(3), e0248867. https://doi.org/10.1371/journal.pone.0248867
Perone, G. (2021). The determinants of COVID-19 case fatality rate (CFR) in the Italian regions and provinces: An analysis of environmental, demographic, and healthcare factors. Science of the Total Environment, 755, 142523.
Perone, G. (2022). Assessing the impact of long-term exposure to nine outdoor air pollutants on COVID-19 spatial spread and related mortality in 107 Italian provinces. Scientific Reports, 12(1), 13317.
Pijls, B. G., Jolani, S., Atherley, A., Derckx, R. T., Dijkstra, J. I., Franssen, G. H., & Zeegers, M. P. (2021). Demographic risk factors for COVID-19 infection, severity, ICU admission and death: A meta-analysis of 59 studies. British Medical Journal Open, 11(1), e044640.
Raghupathi, V., & Raghupathi, W. (2020). Healthcare expenditure and economic performance: Insights from the United States data. Frontiers in Public Health, 8, 538294. https://doi.org/10.3389/fpubh.2020.00156
Rechel, B., & McKee, M. (2009). Health reform in central and eastern Europe and the former Soviet Union. The Lancet, 374(9696), 1186–1195. https://doi.org/10.1016/S0140-6736(09)61334-9
Ritchie, H., & Roser, M. (2017). “Obesity” Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/obesity. Accessed 28 October 2023.
Ritchie, H., & Roser, M. (2019a). “Age Structure” Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/age-structure. Accessed 2 November 2023.
Ritchie, H., & Roser, M. (2019b). “Gender Ratio” Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/gender-ratio. Accessed 20 October 2023.
Ritchie, H., & Roser, M. (2022). “Alcohol Consumption” Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/alcohol-consumption. Accessed 28 October 2023.
Ritchie, H., Rodés-Guirao, L., Mathieu, E., Gerber, M., Ortiz-Ospina, E., Hasell, J., & Roser, M. (2023). “Population Growth”. Data adapted from Gapminder, PBL Netherlands Environmental Assessment Agency, United Nations, Food and Agriculture Organization of the United Nations. Retrieved from https://ourworldindata.org/grapher/population-density. Accessed 14 October 2023.
Ritchie, H., & Roser, M. (2023). “Smoking” Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/smoking. Accessed 28 October 2023.
Ritchie, H., Samborska, V., & Roser, M. (2024). “Urbanization” Published online at OurWorldInData.org. Retrieved from: https://ourworldindata.org/urbanization. Accessed 20 October 2023
Robert Koch Institute. (2023). Covid-19 outbreak: Situationsberichte. Retrieved from: https://www.rki.de/EN/Content/infections/epidemiology/outbreaks/COVID-19/Situationsberichte_Tab.html. Accessed 17 December 2023.
Rüttenauer, T. (2022). Spatial regression models: A systematic comparison of different model specifications using Monte Carlo experiments. Sociological Methods & Research, 51(2), 728–759. https://doi.org/10.1177/0049124119882467
Sarkodie, S. A., & Owusu, P. A. (2020). Impact of meteorological factors on COVID-19 pandemic: Evidence from top 20 countries with confirmed cases. Environmental Research, 191, 110101. https://doi.org/10.1016/j.envres.2020.110101
Sasson, I. (2021). Age and COVID-19 mortality. Demographic Research, 44, 379–396. https://doi.org/10.4054/DemRes.2021.44.16
Sen-Crowe, B., Sutherland, M., McKenney, M., & Elkbuli, A. (2021). A closer look into global hospital beds capacity and resource shortages during the COVID-19 pandemic. Journal of Surgical Research, 260, 56–63. https://doi.org/10.1016/j.jss.2020.11.062
Shao, Q., Tao, R., & Luca, M. M. (2022). The effect of urbanization on health care expenditure: Evidence From China. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2022.850872
Shapiro, S. S., & Wilk, M. B. (1965). An analysis of variance test for normality (complete samples). Biometrika, 52(3/4), 591–611. https://doi.org/10.1093/biomet/52.3-4.591
Shenoy, A., Sharma, B., Xu, G., Kapoor, R., Rho, H. A., & Sangha, K. (2021). God is in the rain: The impact of rainfall-induced early social distancing on COVID-19 outbreaks. Journal of Health Economics, 81, 102575. https://doi.org/10.1016/j.jhealeco.2021.102575
Shulzhenko, D. (2020). Ukraine’s top sanitary doctor: 240 hospitals, 67,000 beds ready for COVID-19 patients, Kyiv Post, March 31, 2020. Retrieved from: https://archive.kyivpost.com/ukraine-politics/ukraines-top-sanitary-doctor-240-hospitals-67000-beds-ready-for-covid-19-patients.html. Accessed 11 December 2023.
Smirnova, O. V., Bobrovsky, M. V., Khanina, L. G., Voskresensky, I. S., Zukert, N. V., Bykhovets, S. S., & Turubanova, S. A. (2017). Natural conditions and general descriptions of forest vegetation and forest soils. In O. Smirnova, M. Bobrovsky, & L. Khanina (Eds.), European Russian forests. Plant and vegetation. (Vol. 15). Dordrecht: Springer.
Sorensen, R. J. D., Barber, R. M., Pigott, D. M., Carter, A., Spencer, C. N., Ostroff, S. M., & Murray, C. (2022). Variation in the COVID-19 infection-fatality ratio by age, time, and geography during the pre-vaccine era: A systematic analysis. The Lancet, 399(10334), 1469–1488. https://doi.org/10.1016/S0140-6736(21)02867-1
Sorsa, V. P., & Kivikoski, K. (2023). COVID-19 and democracy: A scoping review. BMC Public Health, 23(1), 1668. https://doi.org/10.1186/s12889-023-16172-y
Squarcina, M., Carraro A., Otchere F., & Richardson, D. (2023). War and Economic Downturn: The impact of the war in Ukraine and the subsequent economic downturn on children and families in Europe and Central Asia. UNICEF Innocenti—Global Office of Research and Foresight, Florence, July 2023. Retrieved from: https://www.unicef.org/eca/reports/impact-war-ukraine-and-subsequent-economic-downturn-child-poverty-eastern-europe. Accessed 10 October 2024.
Statbank. (2023). Statistical database. Retrieved from: https://statbank.hagstova.fo/pxweb/en/H2/. Accessed 13 December 2023.
Statistics Faroe Islands. (2021). A more equal income distribution and fewer people at risk of poverty in 2019, November 12, 2021. Retrieved from: https://hagstova.fo/en/news/more-equal-income-distribution-and-fewer-people-risk-poverty-2019. Accessed 5 October 2023.
Statistics Faroe Islands. (2023). Accomodation: Stays and tourists by country of residence. Retrieved from: https://hagstova.fo/en/business/i-accommodation-and-food-service-activities/accomodation. Accessed 3 December 2023.
Strauss, T. (2017). Generalising ward’s method for use with manhattan distances. PLoS ONE, 12(1), e0168288. https://doi.org/10.1371/journal.pone.0168288
Strauss, T., & Von Maltitz, M. J. (2017). Generalising Ward’s method for use with Manhattan distances. PLoS ONE, 12(1), e0168288. https://doi.org/10.1371/journal.pone.0168288
Tambor, M., Klich, J., & Domagała, A. (2021). Financing healthcare in central and Eastern European countries: How far are we from universal health coverage? International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph18041382
Tarkhnishvili, N. (2020). How prepared is georgian healthcare system for COVID-19 pandemic? Civil.ge, March 13, 2020. Retrieved from: https://civil.ge/archives/342281. Accessed 4 December 2023.
Tartof, S. Y., Qian, L., Hong, V., Wei, R., Nadjafi, R. F., Fischer, H., & Murali, S. B. (2020). Obesity and mortality among patients diagnosed with COVID-19: Results from an integrated health care organization. Annals of Internal Medicine, 173(10), 773–781. https://doi.org/10.7326/M20-3742
Tekerek, B., Günaltay, M. M., Ozler, G., & Turgut, M. (2024). Determinants of COVID-19 cases and deaths in OECD countries. Journal of Public Health, 32(3), 473–484. https://doi.org/10.1007/s10389-023-01820-9
The Luxembourg Government. (2021). Ministry of health and social security: New COVID-19 cases—Weekly review: 8–14 November, (published on November 18, 2021). Retrieved from: https://m3s.gouvernement.lu/en/actualites.gouvernement%2Ben%2Bactualites%2Btoutes_actualites%2Bcommuniques%2B2021%2B11-novembre%2B17-retrospective.html. Accessed 22 November 2023.
The Government of the Faroe Islands. (2021). Korona í Føroyum. Retrieved from: https://korona.fo/news. Accessed 15 December 2023.
Tobler, W. R. (1970). A computer movie simulating urban growth in the Detroit region. Economic Geography, 46, 234–240. https://doi.org/10.2307/143141
Turcu-Stiolica, A., Kamusheva, M., Bogdan, M., Tadic, I., Harasani, K., Subtirelu, M. S., & Petrova, G. (2021). Pharmacist’s perspectives on administering a COVID-19 vaccine in community pharmacies in four balkan countries. Frontiers in Public Health, 9, 766146. https://doi.org/10.3389/fpubh.2021.766146
UNESCO. (2023). UNESCO institute for statistics. Retrieved from: http://data.uis.unesco.org/. Accessed 29 November 2023.
United Nations Moldova. (2021). COVID-19 response and recovery monthly bulletin—November 2021. Retrieved from: https://moldova.un.org/sites/default/files/2021-12/UN%20Moldova%20Covid-19%20Response%20and%20Recovery%20Monlthy%20Update-%20November_2021.pdf. Accessed 15 December 2023.
Upadhyaya, A., Koirala, S., Ressler, R., & Upadhyaya, K. (2022). Factors affecting COVID-19 mortality: An exploratory study. Journal of Health Research, 36(1), 166–175. https://doi.org/10.1108/JHR-09-2020-0448
Verulava, T., & Maglakelidze, T. (2017). Health financing policy in the south caucasus: Georgia, Armenia, Azerbaijan. Bulletin of the Georgian National Academy of Sciences, 11(2), 143–150. Retrieved from: https://eprints.iliauni.edu.ge/6592/. Accessed 12 October 2024.
Viezzer, J., & Biondi, D. (2021). The influence of urban, socio-economic, and eco-environmental aspects on COVID-19 cases, deaths and mortality: A multi-city case in the Atlantic Forest. Brazil. Sustainable Cities and Society, 69, 102859. https://doi.org/10.1016/j.scs.2021.102859
Ward, J. H., Jr. (1963). Hierarchical grouping to optimize an objective function. Journal of the American Statistical Association, 58(301), 236–244. https://doi.org/10.1080/01621459.1963.10500845
Wildman, J. (2021). COVID-19 and income inequality in OECD countries. The European Journal of Health Economics, 22, 455–462. https://doi.org/10.1007/s10198-021-01266-4
World Health Organization. (2023). The global health observatory. Retrieved from: https://www.who.int/data/gho/data/indicators. Accessed 10 December 2023.
World Bank Poverty and Inequality Platform. (2023). With major processing by Our World in Data. “Share of population below 50% of median income or consumption—World Bank”. Retrieved from: https://ourworldindata.org/grapher/relative-poverty-share-of-people-below-50-of-the-median. Accessed 4 November 2023.
World Bank. (2023a). Climate change knowledge portal. Retrieved from: https://climateknowledgeportal.worldbank.org/. Accessed 18 November 2023.
World Bank. (2023b). Universal health coverage global monitoring data—2021 (updated 18 January 2023). Retrieved from: https://datacatalog.worldbank.org/search/dataset/0060802/Universal-Health-Coverage-Global-Monitoring-Data---2021. Accessed 20 December 2023.
World Bank. (2024). World bank open data. Retrieved from: https://data.worldbank.org/. Accessed 25 September 2024.
Wu, C., & Qian, Y. (2022). The gender peak effect: Women are most vulnerable to infections during COVID-19 peaks. Frontiers in Public Health, 10, 937179. https://doi.org/10.3389/fpubh.2022.937179
Wu, Y., Jing, W., Liu, J., Ma, Q., Yuan, J., Wang, Y., Du, M., & Liu, M. (2020). Effects of temperature and humidity on the daily new cases and new deaths of COVID-19 in 166 countries. Science of the Total Environment, 729, 139051. https://doi.org/10.1016/j.scitotenv.2020.139051
Xie, L., Yang, H., Zheng, X., Wu, Y., Lin, X., & Shen, Z. (2021). Medical resources and coronavirus disease (COVID-19) mortality rate: Evidence and implications from Hubei province in China. PLoS ONE, 16(1), e0244867. https://doi.org/10.1371/journal.pone.0244867
Yoo, W., Mayberry, R., Bae, S., & Singh, K. (2014). A study of effects of multicollinearity in the multivariable analysis. International Journal of Applied Science and Technology, 4(5), 9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318006/
Zintel, S., Flock, C., Arbogast, A. L., Forster, A., von Wagner, C., & Sieverding, M. (2023). Gender differences in the intention to get vaccinated against COVID-19: A systematic review and meta-analysis. Journal of Public Health, 31, 1303–1327. https://doi.org/10.1007/s10389-021-01677-w
Funding
The author declares that no funds, grants, or other support were received during the preparation of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The author has no relevant financial or non-financial interests to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Perone, G. The impact of public healthcare system on COVID-19 mortality rate in selected European and South Caucasian countries. Eurasian Econ Rev (2025). https://doi.org/10.1007/s40822-025-00310-5
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40822-025-00310-5